Edited - Ermi To Prof
Edited - Ermi To Prof
First, all the glory and thanks to God for comforting me With his words in the most
difficult and darkest phase of my life in the last study years which seems difficult for
human beings to pass that affected every part of my life. He made it possible for me to
complete this journey successfully. My special heartfelt appreciation and gratitude would
belongs to my main advisor Assistant professor Gemeda Odo for his constructive comments
and guidance starting from the proposal writing to the completion of this thesis work.
I am also grateful to Professor Durga Rao Pedada, my instructor and former Head
Department of Social Anthropology at Bule Hora University, for his fatherly role both in
academic and financial assistance during my study. His advices and tips, his long experiences
that he shared to me in the field of Medical Anthropology helped me to build myself a lot.
Also I would like to express my sincere thanks to the government bodies of Kenna district
who allowed me to conduct this research and gave me the necessary help.
Also, i would like to express my gratitude to traditional healers, community elders and other
various community members in the villages i have selected for this study for their sharing of
their knowledge and experience. Without you the study would not have meaning since you
are the sole source of information for this study.
If don’t forget to mention My mom Kayasa, Beyene for encouraging and comforting me
during those times when I lost hope and decided to withdraw from this study. I say may
God Almighty bless her abundantly. The another big thank is for my wife Merry Gelgelo,
While i have a lot of family responsibilities, she holds the full responsibility of our family.
This helped me to focus only on my study. I thank you very much.
Finally, I like to express my profound gratitude to all of you who have contributed in the
success of this study in various ways.
Abstract
Every culture has its own beliefs and practices regarding health, illness, and healing. These
belief systems and practices vary from one society to society. Earlier studies focused on
traditional medicine and its administration in relation to certain diseases and health
problems. This study explores the ethno-medical knowledge and healing practices of the
Konso of Kenna district, south western Ethiopia. It is aimed at focusing on symbolic aspects
of ethno medical knowledge and practices in the area. By employing qualitative research
approach, data were gathered through primary and secondary sources. Primary data was
collected through in-depth interviews, key informant interviews, and non-participant
observation and case studies. Secondary data was collected through critical review of
related literature from books, previous research works, articles and government office
reports. The information obtained in the field and from written documents were transcribed,
organized, categorized in to themes and then analyzed and presented by qualitative data
analysis approach. Research participants were selected from four villages viz. Kaho,
Debena, Mecheke and Fasha of Kenna district, south western Ethiopia based on purposive
sampling technique. In these areas ethno-medical practices and traditional healers were
found in abundance than the rest areas.
The study found that for Kena, Health (Ngaytta) is an important aspect which all needs in
their daily interaction and something which highly valued. They had holistic view about
health. For them the Sky God is the provider of good health. Good health state for them is
beyond proper functioning of body or the absence of disease. For them health involves
physical health, mental or and moral health. For them the occurring of some sort of illness is
identified through forecasting mechanism. There are cultural practices and ways to predict
any illness cases that would happen in their future. . These are investigation on animal flesh,
observation of heavenly bodies, ancestral calling and movement direction of domestic
animals are among the ways trough which they do this. Thus, there are ethno medical
methods of preventing and controlling diseases and illness before they occur and harm on to
people's health.
The findings also identified some rituals practices which have key role in the prevention of
illness. Rituals like, tuta ceremony, generation tree, illness transfer, purification rituals, and
consulting diviner are among common ways of preventing illness.
The findings also indicated that the attributions of illness as the consequence of violations of
the core social values are the main direct agents of social control. The community attributes
illness to multiple causative agents. Violation of social norms, disobeying taboos, witchcraft,
black magic, evil eye and evil spirit are the spiritual and supernatural causes of ill health in
the study area. They also regard some illness as result biological and hereditary factors.
Finally, the study area is known for wide ethno medical healing practices. They range from
spiritual healing to simple non spiritual healings. The main traditional healers include: bone
setters), traditional midwives, massagers, healing magic and herbalists. Most healers were
experts of more than one speciality. The sources of herbal medicines were from plant and
animal products. Herbalists did not share their knowledge for other party. These herbal
medicines are now not widely available due to climate change and environmental
degradations.
CHAPTER ONE
INTRODUCTION
2.1.DEFINITION OF TERMS
Ethnomedicine
social
choice of
controlling
treatment
mechanisms
social order
and welbing
2.6.THEORETICAL FRAMEWORK
Although there are many theoretical approaches in medical anthropology, the researcher
attempted to explore three major theoretical approaches which helped to understanding health
and illness beliefs and the meanings attached to it. Thus, phenomenological approach,
interpretive approach and ethno medical approaches in the fields of medical anthropology
were appropriate ones for this research investigation and they are explored below.
2.6.1.PHENOMENOLOGICAL APPROACH
Phenomenological approaches have become increasingly important in anthropology
throughout the past 25 years. They have contributed greatly to how anthropologists think of
lived experience, illness and healing, suffering, violence, morality, bodily illness, sensory
perception, communicative practices, mind and consciousness, creativity and aesthetic
efforts, and subjectivity and inter subjectivity, among other themes and topics. More
generally, they have helped anthropologists to reconfigure what it means to be human, to
have a body, to suffer and to heal, and to live among others (Desjarlais, R., and Jason Throop,
C. 2011).
In phenomenological anthropology, cultural reality is understood as a life world. This means
interpreting meanings as a lived inter-subjective reality. Symbolic systems, as they are
expressed in, for example, rituals and doctrines, can only be understood in relation to the life-
world of the people involved (Knibbe, K., and Versteeg, P. 2008). In phenomenological
anthropology, however, there is a much greater emphasis on experience, the ongoing ‘flow’
of life and the anthropologist as a person who participates ‘sensuously’ in different life-
worlds (Stoller, 1997 cited in Knibbe, K., and Versteeg, P. 2008).
In this approach the focus is on the way in which meanings become and are reality to the
people themselves: how meanings appear to them and coincide with the practical everyday
world in which one needs to survive (Knibbe, K., and Versteeg, P. 2008).
Furthermore, In phenomenological method , taking the ‘apprenticeship’ of an anthropologist
in a new life-world seriously means looking for meaning as something that appears to our
senses, something that anybody can immediately understand because of our shared human
nature, but also learn through becoming an insider. Participation in a life-world, through
apprenticeship and ultimately as a capable actor, is at the centre of the phenomenological
method (ibid:123). For this study this theory will helped the researcher to look at the
meanings behind lived experiences of health, illness and healing practices of the study area. It
helps the research to gain an understanding meaning of everyday experiences in relation
with health and illness in the study area
Indeed this phenomenological perspective helped in this study to understand the lived
experience that the community under study follows to forecast, prevent and control disease
and illness. In line with the different ritual practices and the symbolic meanings attached to
them can be only understood as reality by actors who involved in it.
2.7.THE INTERPRETIVE APPROACH
The Interpretive theory comprises various frameworks that emphasize the study of meaning
rather than scientific explanations (McElroy and Townsend 2004). Cultures throughout the
world use different systems of meaning to describe and respond to illness. Anthropologists
who study these differences with symbolic meaning employ the interpretivist approach to
medical anthropology. Good (1994) in Kleinman (2009) also uses anthropological analysis to
show how “meaning” is created in illness, how cultural values and social relationships, the
experiences of the body and sickness situate suffering in local moral worlds. The concept of
‘explanatory models’ of illness proposed by Kleinman (1978: 187) to elicit what he referred
to as the ‘native’s point of view’, introduced a radical change of perspective in the
understanding of the relation between the cultural domain and the domain of disease.
The interpretive approach has been dealing with problems of adequately representing illness,
suffering and experience in ethnographic accounts. It also deals with the problematic relation
of experience to cultural forms such as narratives and the grounding of such experience in
local moral worlds (Kleinman 1991). The interpretive tradition examines the construction of
interpretations in different social contexts. That is: “how meaning and interpretive practices
interact with social, psychological, and physiological processes to produce distinctive forms
of illness and illness trajectories” (Good, 1994:54). The various social and cultural beliefs,
attitudes and behaviours constructed in due course of time within the study community and
their power in shaping their attitudes towards health and illness was best described in this
theoretical perspective. The way Kenna community define good health and ill health; the
agents to which they think as the cause of illness all were socially and culturally constructed
during complex social interactions.
2.8.APPROACH OF ETHNOMEDICINE
This ethno medicine is the most important approach to define and understand the general
ideas related with health and healing practices of the people under study. Fabrega (1975:969)
defines ethno medical inquiry as the study of how members of different cultures think about
disease and organize themselves toward medical treatment and the social organization of
treatment itself. Ethno medicine examines local ideas and behaviours surrounding how to
stay well, and how to treat sickness.
A basic concept in ethno-medicine is "explanatory model" which is introduced by Arthur
Kleinman (1980). Explanatory models (EMs) are notions about the causes of illness,
diagnostic criteria, and treatment options. In a clinical encounter, the EMs held by
practitioners, patients, and family often differs. The ensuing communication and negotiation
of decisions for managing illness lead to the cultural "construction” of illness.
Ethno-medical studies are conducted to evaluate the efficacy of traditional health care
practices; the prevalence of illnesses and the distribution of knowledge about illness
attributes; the negotiations and instantiation of illness identities; the power of discourse to
produce as well as cure affliction; discourse as moral commentary; linkages between medico-
religious institutions, models of self, power and the state (Bhasin, V., 2007). Hence this
perspective deals with the general notations of health and illness and healing practice of a
particular community, the ideas of causes of illness and prediction and controlling measures
as well the diagnosis and treatments methods of Kenna community would be well defined in
this perspective.
CHAPTER THREE
AREA AND PEOPLE
Under this Chapter the empirical findings the researcher obtained during the data collection
of the study was presented. Findings in relation to ethno medical knowledge of health and
illness perceptions were analysed and discussed briefly. At first this chapter explored
communities perception concerning the state of good health and ill health. It also presents
cultural and symbolic beliefs and mechanism of forecasting illness and the prevention
strategies. Local belief systems and perceptions concerning the causes of illness were also
discussed. In line with the role these local illness and disease perceptions and their role of
serving as the agents of social control and maintaining community wellbeing was also
presented. And lastly, indigenous health treatments and the subsequent healing mechanisms
and process of the study area broadly described and briefly analysed.
Ajima,O. G., and Ubana, E. U. (2018) mentioned that good health and wholeness of being
are phenomena of universal and perennial human interest and people of different cultures
view these concepts differently. Health is defined by the World Health Organization (2007)
as a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity. This notion leads us to conclude that the assumptions and the way people
define the state of good health and ill health varies from culture to culture and is something
examined not examined by physical health. This topic focuses on the community understand
the attributes of a healthy person and ill person.
The term “Nagayta” is local term which stands for wellness. They have a local saying which
explains how health is important and something very expensive as “Nagaytawu Kelli
meaning become wellness is above all. With this in the community if someone goes to
somebody’s home as a gust and if they tell them they have nothing to eat in their home, the
gust usually replies “Nagaytan Damma” which is translated as health is enough, a notion to
show Healthiness as one thing every individual needs in their everyday life to ensure his
wellbeing. “Baqqa” stands for any type of disease that affects person’s health conditions and
Surmmtta (Illnesses) represents the feelings an individual experiences after affected by
disease. For the community under study, health (Nagayta) is more than material things
somebody possesses and highly valued by them. Some argues that wellness or health is
provided by Waqa (God) to those who adhere to and live according to norms and guidelines
set by the community. Words like nagaytan Qabu (he/she is not well), Epaqinin (He is ill)
and Esha inaaktu ( he is not feeling good) are the local words often used to express healthy
living . For the people under study, health is holistic means it involves physical health, mental
(spiritual) health as well as behavioural (moral) health both in the individual and the
community. These definitions of good health and ill health were discusses below.
5.1.1 PHYSICAL HEALTH (NAGGAYTA/ A, DAKINTAA)
The first criteria to define health is basis the feelings somebody’s feel on their body. Dakintta
is a local term to describe both outer and inner part of human body. According to FGD data,
what people feel in their body determines whether they are healthy or not. If somebody
functioning ability is normal he is in proper health condition and if somebody has the feeling
pain and discomfort in his body and suffering from that feeling he is not in a good health.
Thus ‘Surmmtta’ illness is the pain and discomfort in physical body. This view of health has
the same concept with western medical concept of health. Thus it looks health from the
notion of absence disease or aliment.
5.1.2 STATUS OF MENTAL HEALTH (NAGAYTTA A’ MATTA)
The mental health status of an individual is the other component to which the Kenna
community defines good health and ill health. As FGD data shows, a normal mental status is
when individuals have good cognitive and psychological functions and unlike this those who
have weak cognitive functions are mentally ill. Data from FGD indicates there are factors
that cause mental illness or problems. Some of them are chichi tolaa (family curse), Mirra
Karraya (ancestral punishments), (tiba) witchcraft and kodkoda (sorcery). My informants
also stressed that in some cases the problem mental illnesses are inherited from parents who
are previously mentally ill or suffering from mental problem. Thus mental illnesses in some
cases are caused by genetic factors. In addition to the above factors, social problems such
as , disruption of life, death of close family member, sadness, depression, incurable physical
health problem and not having a baby son, loss of hope within individuals makes people to
have mental health problem. In the study are there are a number individuals who commit
suicide due to their mental disorders.
5.1.3.HEALTH IN RELATION WITH ONES MORAL AND BEHAVIOURAL
CHARACTER
The other of aspect defining good health and ill health is all about the status of someone’s
moral and behavioural character. According to my informant, people with good moral
character are considered as someone who has good health. According to his response
respecting parents (father and mother) and elders, one who loves work, one who respect and
guided by values of the community are seen as healthy person. In contrast to the above idea,
he argued that those who are not guided by the community rules and values are considered as
unhealthy or those with ill health. Thus, a person who create martial relationship or had a
sexual relationship with a kin group or close relative, one who wastes his father’s property,
disobedient, one who insult others and in general people with these other similar immoral
behaviours are taken as unhealthy sections of the community. Good health involves having
healthy relationships with family, relatives and the wider community. It is also is all about
interacting and participating in the community issues. Those who have less social
connections with outside community are considered as unhealthy. In their understanding
good personality, appropriate behaviour and living in accordance with the values and norms
of the traditions of society is the defining feature good health and ill health. Having good and
harmonious relationship with the surrounding (family members, relatives, neighbour and the
rest community qualifies somebody as health person.
This associating good health and ill health in relation to one’s moral behaviour and personal
character in a society affirms the concept of health is more than the physical and mental
aspect of health. It clearly shows that respecting and obeyed by communities social norms
and values is sigh of healthy person while disrespecting and not guiding by these social
values and norms is the sign of unhealthy person.
Health (Nagaytaa)
According to my key informant Aleto Giroya, among the community there are elders who
have special knowledge of looking for symbols and events which are referred as
“Toyyanbaya” or observers. While those who ideally predict about things which will be
happen in the future are “Xumanbayya”. If something evil, epidemic diseases and death was
going to happen within and among the family level or the whole community, the above
experts use the following common local sayings:
“Wa Neqa, a Tolupuba Dennii’ meaning something bad is probably going to happen to
family
‘Wa Neqa, a Orupuba (samaytupupa) Dennii’ meaning something bad is probably going to
happen to the community
“Tota xarupa kulini” meaning death is coming through the gate
With these the major local techniques of forecasting these health problems were identified
and presents as follows.
5.2.1 HARUSIPICATION (MARQQINA TOYYA)
According to the study data, any illness or harm that may occur in the community is seen in
the flesh of animal. Thus in kenna area the signs that are seen on the intestines of slaughtered
animal (Marqqina) shows the kind of illness or harm that may happen at individual, family
and community level. According my key informant Aleto Giroya, if somebody has going to
die or to going be killed, the signs which are seen on the “Marqqina” tell the kind of his
death situation. The sign may clearly shows that the person is going to be killed either by
spear or weapon. This allows them to easily identify the types of illness that are going to
affect individuals, family and the broader community. It also allows knowing the causes of
accident and the extent of harm.
5.2.2.TOYYA MONTTA (OBSERVATION OF HEAVENLY BODIES)
Another cultural experience of forecasting illness and disease occurrence in the study area is
by looking at the symbols and signs formed around moon and Stars and the movement and
direction of sun in the sky. According my key informant from kaho village, the circular signs
formed around the moon and stars explain or show the possibility of disease, drought and fire
accident in the community. Toyyanbayya (experts of heavenly bodies) is the name given for
those individuals who have special knowledge of reading and explaining the signs and
symbols formed around them. The position and movement stars and moon are readable and
meaningful to the Toyyanbayya (observers).
Aleto Giroya is my key informant from kaho kebele. He best known for observing and
reading of these heavenly bodies like star and sun to predict and divine the entire health
situations and other social and economic aspects the community may face in the future. The
picture below is a photo i took of Mr Aleto in the morning sitting outside his residence while
the sun was rising and reading each and every direction movement of the star and sun.
Picture 4. Elder Aleto, a well known community elder photo taken by Ermias.
observing the movement and direction of sun during sunrise in front of his residential home
levels illness
contolling and
prevention
Individual
level
Family level
Community
level
The main findings about the mechanisms the community in the kenna area practices to
prevent and control the early happing of disease in the following sections.
5.3.1.PREVENTION OF DISEASE AND ILLNESS BY PERFORMING RITUAL
(KILLANA)
The community under study area is known various kinds of rituals, by which each of them is
conducted and performed for their own purpose. Among these rituals, those which are
regularly performed and celebrated in order to prevent evil things, disease, epidemics and
other things that can harm the society are the most common . Based on the data, these rituals
were categorized into two such as periodic rituals, those that are conducted at regularly
spaced intervals. They are performed in respect of their seasonal schedule. The second ones
are those which are carried out by the circumstances: are those rituals conducted in
circumstances where something is about to happen to an individual or to the family and the
society, it will be done immediately as a response against what is going to happen.
5.3.1.1.PERIODIC RITUALS
The most common periodic rituals are Tuta Ceremony (thanks giving event specific to kena
area)) and xeleta Taparisaa (Power transfer) are the major ones.
a. TUTA CERMONY
Tuta is cultural festive accompanied by deep ritual ceremony is held every year in the middle
of June month. It is a cultural ceremony unique to kena area as my informants told me. They
explain by saying that on the Tuta ceremony we condemn evil and bad things, we seek good
health from God, and we pray that diseases and illness as well as misfortunes will be away
from us. They also argued that” this the tuta ceremony has been neglected for some years
Due to the lack of respect for the culture among the young generation and the denials made
from the members of Christianity religion of the time. As a result we exposed to various
illness, continues drought and famine. However, now that we have started conducting the
ceremony again, all these things have disappeared.
In the whole konso, political power, like today, peacefully passed from the older generation
to the younger one after a fixed period of years (Shako, 2004:51) cited in Gellebo, K. (2011).
Dried juniper tree was erected by the age grade group to signify the transition of power to the
next generation in every nine years. To support the role of this cultural ceremony in
maintaining the health of the community, Hallpike, C. R. (2008:96) stated like this
“Associated with these systems are a number of ceremonies the purpose of which, broadly
speaking, is to ensure rainfall, the fertility of the fields and crops, and of women and
domestic animals, the absence of disease, internal peace, good hunting, and success in
warfare”.
According to key informant, conducting this ritual ceremony in its specified period keeps
their health safe and prevents every evil thing and bad lucks that will be going happen to the
community. It was believed that giving up their traditional ceremonies would cause sickness
and death.
5.3.1.2.RITUALS CARRIED OUT BY CIRCUMSTANCES
In the study community, it is common to prepare and perform different ritual ceremonies and
events either in order to fully control the happened health problem or minimise the spread of
illness and infectious where they occurred. The researcher described some of these preventive
practices in the following section.
A. QOYRITTA TAWISSA (THROWING OF STICK)
Among the study population, it is common practice to transfer misfortune, epidemic, disease
and sickness of one’s individual or group onto another person or community. When an
epidemic disease or some bad event will happen or happened either among family members
or in their neighbourhood, they perform ritual practice locally called Qoyritta tawissa means
to expel the disease and any other misfortunes from themselves and make it transfer person or
group/area. Regarding this one of my informant from Fasha village explained as follows:
“At any time when some kinds of infectious or health problem occur in our family or in our
living area/vilage, we have a traditional ritual practice that we use to protect ourselves from
harming us or being attacked by it. Thus, depending on the nature of the illness, there are
things that we take, for example, stick, salt, cotton thread, etc. We take one of these and
throw it to the village or across the border and return back. Then the previous situation will
go away from us. That means that we banish and expel that bad thing from our
surroundings”.
Based on the description, the community under study believed that taking and dropping such
material outside of their boundary is the Supposed as moving away or averts the observed
health problem from them.
B. NEQUMTTA BATISA (PURIFICATION RITUALS)
In the study it is common to regularly conducting cleansing and purification rituals to prevent
illness and bad luck. These rituals process in ordinary conversation called Nequmtta Batisa- a
cleansing process of any wrong behaviour among those who involved. My informant
explained to me that they perform these rituals seriously, because they belief that performing
the symbolic ritual purification has real outcomes and effects on their health and wellbeing.
According to him, it is done to bring back the previous normal occasions, to show repentance,
to restore the lost good relationship. It is all about transformation from wrong anti-social
behaviour to right one, and from doing wrong things to thinking good.
To the people of kenna, “Purity” is an important aspect it is believed to be the only way to
achieve good things. It often takes different forms, like at individual, family level and village
levels. Thus the purification rituals are the symbol and sign of preventing illness and
misfortunes at sections of the community under study. This he purification process is usually
carried out with scarification of blood - painting the blood of slaughtered animal on the
surface of objects and places. They belief that the blood has the power of removing all the
bad things happened so far, noticed it as ritual bathing where by the person or members of the
Most People in the study often have consultations with diviner or white magic about their
health conditions. A household head or village elder goes to consult a diviner when
something is wrong or when they worried of something. They consult the soayetta (Magic) to
tell them what they think it might happen to them. “summsata” in local term which stands for
discus (consult) over the matter (issue).
According to excerpts from FGD, it revealed that people in the study area wants to a diviner
to tell them about for health-related problems. The diviner is supposed to tell them the reason
for the happening the issue, the thing that could happen to if they don't consult them and
finally the way the issue should be fixed. He orients them all the necessary actions they
should follow. For public health issues or communal interest, the most known elders were
selected from the community and they meet with the diviner to talk over misfortunes that is
going affect the whole community. This practice of consulting a diviner and other
Cultural values, beliefs, and meanings, have active roles in the causation of disease and the
allocation of remedies. Based on my research findings, the beliefs about the causes illness
and diseases are based on the deep social and cultural narratives’ the people under study. As
i have earlier highlighted in the literature review section scholars categorized the reasons for
illness causation as Naturalistic and personalitiesc factors. According to Foster’s explanation,
personalsitic or unnatural illnesses are caused by two major types of supernatural forces:
occult causes which are the result of non-human evil spirits or human agents using sorcery
and spiritual causes which are the results of penalties incurred for sins, breaking taboos or
caused by God, while the naturalistic view explains illness as something caused by natural
forces or conditions such as cold, heat and possibly by an imbalance in the basic body
elements (Foster, 1976). Most of the research findings in relation with underlying causes of
an illness in the study area confirms with Foster’s taxonomy for causality beliefs in non-
western medical system. However, there are also Hereditary diseases their causes are from
infected parents are not included in the theoretical explanations of most scholars. A clear
description of what a people in the study area believe to be the causes of illness were
discussed below.
Thus parental cursing is one of the reasons for illness, which in turn increases the
communities love and care for parents and also plays a significant role in creating peaceful
society.
As stated by Hallpike, C. R. (2008), the people of under study believe that rainfall, the
fertility of women, animals, and crops, and success in war and hunting, depends on the
maintenance of the above key social norms the community should adhere to and implement
them. thus when these does not reflected in daily life of the community, their environment
will hit by drought because of luck rain fall, people suffer from disease, the infertility of
women’s become prevalent and the unproductively of crops are among the negative
outcomes occurs to the community because of the absence adhering to the core social norms.
In his own explanation, Loyalty, social harmony, peace, sociability, cooperation, and
discussion are fundamental norms to attain the betterment and healthiness of individuals and
the wider community. Disobeying these rituals could lead to severe illness to the person(s) or
community involved.
Regarding this, Hallpike, C. R. (2008), mentioned, how performing these ritual ceremonies
are significant to ensure rainfall, the fertility of the fields and crops, and of women and
domestic animals, the absence of disease, internal peace, good hunting, and success in
warfare.
The informants commented the weakening of these cultural rituals hence they argued that the
major reasons for current occurrence of drought, conflict and other societal problems are
because of failure of regularly undertaking these rituals.
In the study area, some factors of illness or sickness are traced to violation of taboos. As per
the FGD excerpts it indicates that there are traditional religious customs which prohibit and
restrict individuals from doing or involving in some actions or prohibit or restrict a particular
act or practice or forbid association with a particular person, place or thing. And violating
and breaking these restrictions could lead to severe illness and possibly death to the person or
community involved. The informants mentioned that there are various food and marriage
related taboos in kenna community. There are also materials that are absolutely forbidden to
touch them and scared places that some people are not allowed stepping on or passing on.
There is a belief that the violation of taboos can result in punishment in the form of illness.
Clearing a sacred forest (murra) is also believed that it could results in serious health
problem. The most common taboo is “Magnera” or incest taboo, a prohibition of marriage
between the boys and girls of the same clan. In the community under study it was believed
that these children born from them will not be healthy and will die. Not only this, those who
are married in such away are forced to migrate from the area where they live because it is
thought that they will bring bad things to the rest community. It was observed that the
members of same clan are considered as brothers and sisters and therefore no marriage is
done between them known as incest taboo.
In the study area, it was forbidden to women to pass through or enter moraa (A sacred public
place serving for conducting public rituals, cultural dancing, reconciliation, discussions and
traditional games. If women do this, that will pollute the spiritually and physical potential of
the xella grade (the youth generation) by making them infertile. This is a clear illustration that
illness may be as a result of disobedient to the important restrictions and prohibitions of a
particular cultural group.
Picture 5. A sacred morra which womens are not allowed to sit or pass trhough in Fasha
village
According to data, in Kenna community, the koymma or in Amharic “Budda”(evil eye) has
also considered to have special powers to causes sickness and misfortune to a person who is
targeted or harmed by their sight. The jealousy to have the good things on another individual
for themselves is the initial step of this “koymma. They can express their desire either
internally on their heart as well as by speaking by their tongue. They want and look for
everything they think as important and beautiful.
The informant Kayassa from kaho kebele mentioned that, peoples with evil eye have the
potential to cause sickness and malfunctions to humans, animal health, and crop production.
She said they attack human physical body by envying and coveting people’s physical
appearance and beauty. It was believed that those “koymas’s” attack and cause illness to
people’s health without knowing the source of their power. They cause a variety of injuries,
causes pain, loss of consciousness, and even death. They often envious towards beautiful
eyes, long hair, beautiful teeth, fingers and toes. They have the potential to harm human eye
which results in eye pain and blindness. She added saying, they look at and crave at the food
people eat or drink by making it unhealthy and harmful to their health. This allows
individuals to vomit the food they take, causes diarrhea and stomach ache. Surprisingly, it
also makes people never to eat the type food they used to eat at the time. For example, if a
person who loves to eat honey will no longer interested after he is attacked by bees. He also
mentioned about what was happened to her daughter a couple of years ago as follows:
“One day my daughter was going to fetch water from the river. In the neighbourhood she
was known said to have long and beautiful hair. A woman who also came the same to fetch
water unfortunately touched her hair with her hand and expressed her feelings concerning the
length of her hair. Eventually, her hair was wounded and began to fall out in the middle. And
finally As a result, her beautiful attractive hair was badly damaged.”
One of my informants from Mecheke village also said that, in addition to causing illness to
peoples the koymma or an evil eye has also the power to damage and break expensive home
dining and cooking utensils. They have also the power to make cattle’s, sheep unproductive.
From the above point i easily concluded that people with evil eye harms and cause pain and
illness to the people under study. It is still the most prevalent in the kenna community and
most people still fear of evil eye and prevent themselves through various mechanisms
including the followers of modern religion.
For the people under the study, evil spirits are one aspect of the cause of illness. It was
believed that the orrita (evil spirit) are spirits that are scattered and distributed in air, tree,
river, mountain, sea and earth. According to one of my FGD participant, this orrita moves
here and there during day and night. He looks for persons who are travelling for their purpose
at any time. He attack and harm them with various ailments with pains in the side, a bloody
flux from the mouth and nose and mental illness. t is not recommended to travel at noon
hence, it was believed that these evil spirits are moving here and there at that moments.
5.3.2 A HEREDITARY ILLNESS
In addition to the most common illness causing agents it is believed that there are some
illnesses which are transmitted from one generation to the next through gene. This is in cases
when a specific disease affecting a given family transmutes to the next generation and the
children born from them are also affected by the disease. There is an ordinary saying to
explain illness which are specific in given family or group “Tolaaso Paqqa Qabaan”
meaning these families have health problems. diseases such as Mawaa (epilepsy), tesha
(elephants disease) Qomaata (leprosy), Maxenuma (infertility) and etc are supposed to
transmitted through genetic traits. Those who have such kind of problems in the community
don’t participate in marriage alliances and in any other interaction. It was taken as diseases
that are passed down and spread between generations within the family members as a whole.
As the FGD data shows, some physiological dysfunctions, Intellectual disabilities,
Personality disorders and mental disorders have hereditary reasons. Thus the belief among
the people that the reason for some kinds of illness is inherited from an affected parent is the
most widely accepted view in the study community.
The underling perceptions of illness causation in the study has a fewer space for the natural
cause of illness seem to be opposite of the spiritual and supernatural causes mentioned above.
According to one of the KI, some diseases in the study area are attributed to environmental
factors. There is a common understanding in the community that when people move away
from the home resident and stay at their Kommayta (farming and animal breeding camp),
they are exposed to diseases caused by environment factor. The local word Kommayta has the
meaning of desert where there will be very hot weather. To explain this, the informant kusse
teshome from mecheke village said that, when an individual goes to the kommayta (lowlands
areas for farming and animal breeding) and stays there for some time, she/he will be exposed
to the heat of the sun and sweat a lot, causing dryness of the body and, finally he/she gets
infected with malaria. Thus they believe that insect mosquito which is abundant in hot desert
areas is the immediate cause of malaria. In line with this some members of FGD underlined
that due to the expansion of modern education and health care systems now days the young
and educated community members attributed some of the causes of illness to natural or
environmental causes, such as bacteria, germs, contaminated water, and food shortage.
From the above investigations, it was observed that the community under study attributes the
reasons of illness to mutually exclusive aspects or agents acting together.
5.4 PEOPLE’S PERCEPTION ON THE CAUSE OF ILLNESS AND ITS ROLE IN MAINTAINING
With regards to the reasons for ill health, the attribution of illness, suffering and other health
problems as consequence of either breaking of cultural norms or as the punishment by God
within the community makes individuals or groups not to violate the local norms and helps
them to keep from doing wrong behaviour. In this study, an attempt was made to
conceptualize the organized sets of beliefs regarding the factors or conditions believed to
have caused illness and the expected effects of an illness tells them what they should do and
should not do and helps them maintain social order and cohesion. The data show that what
the local community believes in the cause of the disease and illness due to the above agents
would indirectly makes individuals and groups to hold good personality and behaviour. These
beliefs are highly linked with the peoples spiritual and the social orientations which allow
them to develop good personality and right behaviour. And this can directly keep and
maintain social order and regulations of the members of the community.
It is believed that lying , theft or taking the property of others and denying that they did not
take it, false witness, are among unethical practices which the community under study highly
condemned and prohibited. And those who people involved in these bad deeds face the
consequences of punishments such as suffering from illness and even death.
Data from FGD participants revealed that distancing oneself from involving in this ill
behaviour is based on the rational calculation of the cost and consequence that result in health
problems and other related illness.
The key informant Aleto Groya from Kaho village explained why the local people should not
do bad things or engages in bad behaviour as follows:
“In our tradition false witness, disrespecting the peoples, Not accepting or disobeying
decision made by elders of the country, Stealing and denying someone's property, these and
alike are our strict rules that a person does not involve or engage in. Those who commit and
involve in these bad behaviour are punished by the Waqqa (creator) because he the Waqqa
also hates and punish these wrong and evil doers. Because of this, there will be no one who
steals someone's property, no one who bears false witness, no one who takes someone's
property and denies it, and there will be no one who behaves outside the societal norms.
Every ones respects his senor relatives, Young people respect their elders, and we live in
harmony with each other.”
It was noticed that the attribution of illness as the consequences of these wrong behaviours
directly enables the community to work towards doing only right things and avoid wrong
behaviour from their life. In generally, it allows them to have good personalities. The social
rules and behaviours that people develop to become healthy and their roles in promoting
social control and harmony within the study community below.
Integrity is a core value in the study society. Just because integrity has special place. People
share and borrow different things from one other with faith and honesty, without guarantee.
There is amoral responsibility of the recipient to pay back or returning what they have taken
from a person and the giver himself do this without any fear or hesitation. They give cattle,
farm, and money, for their relatives without requiring collateral and written information. And
the recipient protects what he has entrusted. It does what is expected. This integrity and truth
are one of the essential components of order. This honesty and truth is one of the important
elements of the social behaviour which enables individuals and groups to live in harmony and
unity.
Regarding seniority, Hallpike, C. R, (2008) stated that the daughters should marry in order of
seniority, the eldest first, and so on; the same rule applies to the marriage of eldest sons
before their younger brothers. This culture of respect and seniority closes the door of
disagreement, competition over ideas and maintain good relationships within family members
as well as among the groups in the community.
5.4.3 CLEANLINESS AND PURITY
The idea of cleanliness in this study did not represent the physical sanitation rather it stands
for one’s moral and spiritual holiness. It is all about adhering to moral obligations and
prohibitions set out by members of the community. The most common rules norms such an
incest taboo (Megneruma), virginity (Esinkinata) and Adultery (balaguma) are among the
criteria’s to categorise someone weather as clean or impure. With Thus, in the community
one’s sense of separation or connectedness with others members in the community are
determined by having or not having cleanliness. One of my informants suggests that if
individuals or groups are unable adhere to these rules and involves in violating of one of the
restrictions, they are punished by sickness, infertility and other misfortunes.
To generalize this section of the study, it is concluded that the perceptions people hold
concerning what causes illness pushes them to behave in a certain sort of social behaviour
particularly socially accepted behaviours which are thought to bring better health and
wellbeing in the life of individuals and the wider community. These socially upheld
behaviours and norms maintain order and regulations among their community members. It
was identified how beliefs community hold concerning health and illness in some sort is
linked to other elements of the culture.
It was observed that when a person with a broken bone comes to the healer, he should have to
explain circumstances through which his bone gets broken. After that, by touching the part of
the patient's body where the bone is broken, he then confirms the exact location of the
fractured or twisted part of the body and the extent of the fracture based on his diagnostic
experiences. Then gently he massages the broken area with a little hot water for some period
of time to bring the bone back to its place. If it is a broken part is arm or leg, the broken place
is wrapped with animal skin arranges a small piece of wood over the skin and ties it around
with cotton thread. With this, the patient is required to take care of the broken body part
according to the directions prescribed by the healer until the broken bone returns to its place
and get better.
It takes time for a patient to be healed. There are patients who get cured in a short period of
time and there are those who should have follow the treatment for a long time. This is
determined by the extent of the patient's fracture. In this case, that patient who’s their case
requires a time to cure have to follow the regular healing appointments set by the traditional
healer. Kurasho kamayta, aged about 50 years, is a traditional healer mainly known for
restoring and repairing broken and injured bones lives in kaho village of kenna district. He is
also an expert in curing tooth pain.
All traditional midwives and massagers in the study area are experienced in healing multiple
related ailments. They also have their own herbal and other animal products used for
traditional medicine they provide for their patients while they perform their technical healing.
There was an opportunity to attend the healing process of my mother while she is being
treated by a one of traditional midwife. She is Named Kahitiya kapitano. My mother was
suffering from wadaa or rheumatism, It is an illness created in the blood vessels and is
characterized by swelling and twisting of the knee and leg joints. I spent a considerable
amount of time during the healing time. She By spitting on her hand, she massaged the
swollen joint of the patient for a few minutes. Then she mixed the herbal medicine she
prepared from the leaves with water and applied it on the massaged parts of the body. After
she completes, she finally advices here to eat foods that will build her massaged body. But
this massager was not willing to tell about the medicine she applied during healing.
Picture 9. Kahatiya Kapitano, Traditional Massager in kaho Village
5.5.3 SOWAYTA (HEALING MAGIC)
The white or healing magic is the one who always works on healing roles. It is well known
for solving and curing various illnesses in the community. During a discussion with FGD
members of mecheke village, they explained that the sowayta or magic have the ability to
heal in a way that is hard for people to believe. During the time of healing the healing magic
also determine and tells who has caused the illness, through what circumstances’, at what
time and in which these all things happened. He has the ability to expose any hidden evil
things done on an individual. Surprisingly, he may also extract blood or hair from the
affected part of the body. He is also supposed to cure those illness cases which are impossible
to traet in modern health care centres,
5.5.4 ABA QORASHA (HERBALISTS)
Based on the data obtained from FGD participants, there are some individuals in their
community who have extensive knowledge in preparing traditional medicine for various
ailments. These herbal drugs are not only limited to curing purpose. With this there are drugs
which taken to prevent and ward illness. They prescribe these medicines for various health
problems. Unlike those scientific medicines which are tested in laboratory in order to check
their quality, safety and effectiveness, these herbal drugs were passed through a long term
experience of tests and experimentation. According to herbalist key informant, these herbal
medicines were available from two sources. The first is from is Medicinal products of plants:-
They are the main reference prepared from herbs -plant roots, leaves, stems, flowers, fruits or
seeds, and they contain the largest share of medicinal and the other one is Animal product
medicines:- They are the main / reference medicines prepared from animal products like
honey, urine, meat and etc. As FGD data indicates, now days because of climate change and
land degradation this has resulted a huge biodiversity lose and degradation made the immense
herbal medicines unavailable for herbalists.
Some of the lists of herbal medicine and their function in the study area were listed in the
following table.
Table 1. Some Traditional Herbal Medicine and their Purpose in kenna District
No
Illness type Herb used for treatment Method of use
1 Eye infection talpa (Linum usitatissimum) Take three seeds and put in each eye before
Baqqa Elida sleeping. In the morning all sickness and dirt in
the eyes will have been removed
lallata komayta (possibly Crush the leaves together with a cowrie shell and
related to Ricinus put the mixture into cotton lint. Then add water.
communis) Used to bathe the eyes, it cures all eye diseases.
Papaya Crush the seed and mix with water the drink
Kilipoota( Solanum Dig up the root and remove the skin. Chew it and
incaneum) swallow the saliva
15 Kibarata Pumpkin/ passa Grasping the seeds like porridge
16 Lakefeta Shalaqita or qahata tima Crush the leave and smell it on the infected
(infested with person/smell the hot root that comes out of the
demons ) ground to the infected person
17 Itch (qosha) Lawa The root is crushed and rubbed on the body
Ana Kahira( sheep milk) Drinking a little milk of sheep anointing the body
with rest milk
20 Dottita(side qora khonso ( species ) Crush the root and dry it until it becomes a
pain) and powder, and inhale the vapour.
muscle pain
21 Tapeworm and Hinkikata Crush the leaves and mix with water and Painting
parasites on the skin kill parasites. Its seeds swallowed on
an empty stomach will get rid of tapeworm.
Tapeworm and Botata ( pumpkin) Eating pumpkin seed corn helps to get rid of the
parasites tapeworm
The knowledge of herbal medicine in Kena District are not limited to the above listed illness
types and their preventive and treatment methods. During interview with herbalists they faced
a difficulty in remembering all the herbal medicines available in the study area. There are no
written documents of these herbal medicines for references. On the other hand those who the
herbal medicines also refrained from explaining the details about the medicine and usually
the herbal healers hold and keep their knowledge in secrecy.
CHAPTER SIX
SUMMARY AND CONCLUSION
6.1 CONCLUSIONS
The health (Ngaytta) is an important aspect which individuals and groups need in the day to
day life of the study community. It is something which highly valued and is considered as
irreplaceable by any material aspect. For them Waqa (the sky God) is the primary provider of
good health. The used respond the term “Abba Monta Akaltaysamo” (Thanks to the sky God)
while they are greeting each other as way of acknowledging him for providing them with
good health. For them good health is not only about absence disease. There are three aspects
to which they define health including the popular assumption of health. It involves physical
health (Nagayta Dakinta), mental or spiritual health and moral health. The first aspect is what
somebody feels in his body (pain or comfort), mental health about individuals’ cognitive
status and the third is related with personal characters and behaviours someone has in the
community.
Above all they are known for the knowledge of forecasting and predicating the early
occurrences of health problems. And these predictions are the tips of information for the
illness controlling and prevention measures. Harusipication (marqqina toyya), toyya montta
(observation of heavenly bodies), sudden and unusual noises and movements made by home
animals in the homestead and ancestral calling ( halletta karaya) are the common traditional
and symbolic ways to predict what may happen in the future like epidemic disease, death of
individuals and any other problems which are supposed to harm and expose individual and
groups the risk of health problem.
In ethno-medical practices of the study community, people should don’t wait until they get
sick or suffering from some sort of illness. They prefer preventive health culture over the
treatment and healing practices. Thus, there are ethno medical methods of preventing and
controlling diseases and illness before they occur and harm on to people's health. Family
leader, clan leader, community elder and other persons with high spiritual and social status
are qualified to perform these practices. These most prevention strategies are through
performing periodic rituals: tuta ceremony, generation tree (olahitta or qoyritaa xeheltta)
and non-periodic rituals (qoyritta tawissa (throwing of stick) and nequmtta batisa
(purification rituals) and sumssata (consulting diviner or magic) are among common ways of
preventing illness.
The people under the study area have their own understanding and beliefs relating to the
causes of illness. For them, there are multiplicities of illness causation factors. The spiritual
and supernatural causes of illness includes: breaking of social norms and values, failure to
conduct traditional rituals and rites of passage, disobeying taboos, waqqa (the sky god),
ancestral wrath (mirra karayyaa), koyma (evil eye), witchcraft (tibaa), black magic
(sowayta) and evil spirit (orrita). There are some disease that supposed to transmitted by
genetic traits from parents to their lose children’s or immediate kin groups. Additionally,
there are also beliefs that attribute illness to illness natural factors like geographical area and
to bacterial agents.
Most of the illness, sufferings and any other health related aliments in the study community
are believed that they results from breaking and violating of important social norms and
prohibitions. To avoid getting sick the individuals and groups keep themselves from violating
them. And this enables them to have good personality and behaviour. For all these reason
norms and values like integrity, truth, respectfulness, and seniority cleanliness and etc
develop and prevail within the members of the community. This has a profound role in
maintaining social control and wellbeing members of the community. Hence the belief systems
emphasis on the core social values and norms, they act as indirect and direct agents of social
control. Due to the expansions of western religion and modern education as well population
increase, these golden social norms were not given a place by current generation.
The ethno medical healing practices are very wide in the study area. It ranges from spiritual
healing to simple non spiritual healings. While some of healers are specialized specific illness
case others experts in more than one field of specialization. Again almost all of the traditional
healers were not interested to share their knowledge. They do their work secretly in a way
that is not clear to the other party. The main traditional healers include; shemeabaya (bone
setters), xaysotowa (traditional birth attendants), shorambaya (massagers) sowayta (healing
magic) and aba qorasha (herbalists). Herbalists constitute a a large number of healer in the
study area. They prepare these herbal medicines from medicinal products of plant and of
climate change and environmental degradations have made these herbal medicines
unavailable.
6.2 RECOMMENDATIONS
Based on the findings and conclusions made from the study, the following suggestions were
made:
It was evident that the choices of health care systems and health seeking behaviour were
influenced by the societies underlying beliefs about the cause of illness. Thus paying
attention to these local perceptions of the causes of ill health may help governments to
develop best appropriate health policy and as well as to ensure a culturally competent
health care system for their people.
There a numbers of illness cases which have no scientific names and even have no any
treatments modern health care. They are only treated through traditional medical
systems. Therefore, there is a need for joint anthropological and public health
professionals to investigate further analysis on this specific topic.
The Absence of important ritual ceremonies that have a key role and important function
to people’s health is now not consistent. This has exposed people and community to
various illness and misfortune. The local community elders, clan leaders any other
concerned bodies need to take responsibility for these ritual ceremonies to be conducted
without any interruption.
Due to expansion of modern education, there is a widespread tendency among the youth
and the educated groups to consider the ethno-medical practices as age-old ones. Also the
same is true among some followers of Christianity religion to condemn all the things
related with ethno-medical traditions as the works of evil. Most of them refuse to use
traditional herbals hence the regarded it as Gods. Thus, awareness has to be created on the
importance of the ethno medical knowledge to build positive attitude among educators
and religious organisations.
Most of the traditional healers especially herbalists are not able to carefully remembering
some of their skills of herbal medicine. They store their knowledge in orally and it makes
them hard to remember all. Hence, efforts should be made to document traditional
knowledge of the local people properly. They should be disseminated among all members
of the community in order to save the knowledge systems from declining and to make the
knowledge accessible to others.
The people’s perceptions about the cause of illness and its role in marinating the social
order of the community is not something we have to look easily. It helps them to live in
harmony with others, helps them to avoid doing bad things. But the tendency of current
generation is to ignore these perceptions. Thus, it is necessary to teach and orient the
current generation about belief systems make the people and the communities to live in
harmony and order.
While conducting research on ethno-medicine, the Anthropological studies should not
only focus on a single research dimension, but they have to also look for the other
interrelated and interlinked dimensions with main areas of research.
.
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